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Navy & Marine Corps Medical News 


July 28, 2000 

Navy and Marine Corps Medical News (MEDNEWS) is 
a weekly compendium of news and information 
contributed by commands throughout the Navy medical 
department . Information contained in MEDNEWS stories 
is not necessarily endorsed by Navy Bureau of 
Medicine and Surgery (BUMED) , nor should it be 
considered official Navy policy. 

BUMED distributes MEDNEWS to Sailors and 
Marines, their families, civilian employees and 
retired Navy and Marine Corps families. Further 
distribution is highly encouraged. 

Stories in MEDNEWS use these abbreviations after 
a Navy medical professional 's name to show 
affiliation: MC - Medical Corps (physician) ; DC - 
Dental Corps; NC — Nurse Corps; MSC - Medical Service 
Corps (clinicians, researchers and administrative 
managers) . Hospital Corpsmen (HM) and Dental 
Technician (DT) designators are placed in front of 
their names. 


Contents for this week's MEDNEWS: 

— DoD tests medical database for recruits 

— Dental tech perfecting smiles on— board carrier 

— Naval hospital enters e-commerce realm 

— No one gets dogged when it comes to pet therapy 

— NACC accreditation from College of American Pathologists 

— History on display at Naval Hospital Bremerton 

— Anthrax question and answer 

— TRICARE question and answer 

— Healthwatch: Car seat safety should take a back seat 



Headline: DoD tests medical database for recruits 
From Gulf link 

WASHINGTON - Part of the reason it has been so 
difficult to determine the causes of Gulf War 
illnesses is a lack of complete pre— war medical 
records for service members and veterans who have 
developed symptoms . If a new medical program the 
Department of Defense is testing proves successful, 
that problem will not exist for future war fighters. 

Doctors at the Naval Medical Research Center in 
Bethesda, Md. , and the Naval Health Research Center 
in San Diego, Calif. , are investigating the use of a 
baseline medical database to evaluate the health of 
military members and veterans. Capt. Kenneth Craig 
Hyams, MC, said a working group of health 
professionals from the departments of Defense, 
Veterans Affairs and Health and Human Services has 
been collaborating on this project together since 
1996 to develop the Recruit Assessment Program. 

"This is clearly one of the lessons learned from 
our inability to answer Gulf War health questions. We 
need greater baseline data to understand changes in 
veterans ' conditions after they return from dangerous 
deployments, " said Hyams. 

In fact, lessons learned from the Gulf War 
resulted in a complete review of doctrine, policy, 
oversight and operational practices for force health 
protection and military medical surveillance. 
Surveillance in this case means gathering information 
about both the health risks present in the 
environment that our forces are deploying to and the 
health status of service members. Hyams said that in 
today's volatile world, surveillance shouldn't wait 
until after the decision is made to send our forces 
overseas . 

"Preparing for deployment can be an extremely 
rushed and stressful time. It 's hard to get detailed 
and accurate health data once troops begin preparing 
for a potentially life threatening mission, " said 

One way to avoid those pitfalls is to collect 
baseline health data at recruitment and integrate 
this data with health information collected 
periodically during service members' careers. Such a 
database would also help doctors understand service- 
related medical problems from other causes of ill 
health. Without a complete record of the health 
status of recruits when they enter the military, it ' s 
difficult to identify service related health hazards 
— occupational and environmental risks — in the 

Due to the need for improved health 
surveillance , military planners want to create a 
system to track and maintain medical information 
about Soldiers, Sailors, Airmen and Marines 
throughout their military careers. The first step 
will be to gather health data as recruits enter the 
service, including a complete medical history, family 
history, occupational exposures and risk factors. The 
RAP project will do just that with a RAP 
questionnaire. That form, filled out by each recruit, 
will establish a baseline health status for every 
service member on initial entry. 

"We're already implementing the RAP at the 
Marine Corps Recruit Depot in San Diego and the Naval 
Recruit Training Command in Great Lakes, Illinois, " 
said Hyams . Future plans include testing the form at 
the Air Force's Basic Military Training facility at 
Lackland Air Force Base as well. Hyams said that the 
RAP is not a major departure from current medical 
practices . 

Similar baseline information is already 
collected from recruits on Standard Form 93 and 
Standard Form 88, but their data is not 
computerized, " he said. 

The RAP, which is still being refined, is an 
electronically scannable paper questionnaire which 
recruits fill out during their first week of 
training. A copy of the questionnaire will be added 
to each service member's medical folder, while the 
original is fed into a computerized database. That 
process, when applied to more than 250, 000 incoming 
recruits every year, will require the use of cutting 
edge computer technology. 

"We're testing a new generation of software and 
hardware for rapid scanning of large amounts of 
data," Hyams said. "That's being done at the Navy 
Recruit Training Command in Great Lakes, 111 . , where 
the concept of automated medical inprocessing of 
recruits was pioneered in the SHIP program. " 

If successful, the questionnaire will provide 
accessible medical data to both DoD and VA doctors. 
In future years it will be the beginnings of what is 
called a longitudinal database, which allows a view 
of active duty military and veterans ' health over 
time. Linking the RAP with other DoD and VA health 
records will create one of the world's largest 
longitudinal databases. Longitudinal research allows 
doctors to see trends in health problems in a 
population. It will help the military medical 
community better understand differences between 
service members ' pre— and post— deployment health 
conditions . 

He said the ability to see the long term changes 
in an individual veteran's health will help military 
and VA doctors make better diagnoses and offer better 
health care. 

Military planners believe that routine 
collection of medical data from recruits could have a 
substantial impact on health care and illness 
prevention for military members and veterans. They 
say both DoD and the VA would benefit from the 
program by more accurately determining which health 
problems are related to military service. And 
questions about potentially harmful exposures during 
military service could then be more quickly and 
conclusively resolved, allowing for the development 

of Liaproved prevention strategies . 

Personnel from the departments of Defense, 
Veterans Affairs and Human and Health Services are 
working to make sure surveillance goals can be 
realistically achieved for American troops and 
veterans. Hyams sais they should have enough 
information to make a recommendation concerning 
whether or not the RAP should be implemented 
throughout DoD sometime next year. 


Headline: Dental tech perfecting smiles on— board 

By JOl (AW) Kori Ahola 

Aboard GEORGE WASHINGTON (CVN 73) - The sound of 
a dentist's high-speed drill isn't the most relaxing 
sound. With all of the advances made in the past 20 
years in composite materials used to replace teeth, 
there is no reason anyone on board can't have a set 
of pearly whites they can smile about . 

DT3 (AW) Jason Echada contributes to the smiles 
on board USS GEORGE WASHINGTON. He works on 
grinding, filing, buffing, sculpting and smoothing 
prosthetics . 

"I use a lot of specialized equipment to get the 
job done right the first time, " said Echada, the 
ship's only prosthetics lab technician. "We have the 
capability of doing everything from replacing a tooth 
to creating multitooth bridges. I can even create 
gold crowns for a Sailor if it 's required. " 

Enchada works extensively with synthetic 
substances, like white porcelain, that closely 
resemble natural teeth. 

"Replacing a tooth isn't just about aesthetics. 
Having fully functional teeth is important to a 
person's well being, " said Lt . Cmdr. Giacinto 'Jay' 
Rubino, DC, the ship's dental prosthetics officer. "It 
makes me feel good knowing that the crown or bridge 
that I made will be around for a long time. " 

Teeth are very individualistic and are as unique 
as fingerprints. There's a lot of individual 
workmanship and little room for error. 

"When I 'm making a tooth, I try to make it 
resemble the rest of the teeth in size, shape and 
color. If I 'm even a millimeter off, a piece could 
cause pain, " Echada said. 

"You never know when a popcorn kernel is going 
to ruin your day and break a tooth or some other 
dental crisis may arise, " said Rubino. "We do good 
dentistry and this is where it happens. " 


Headline: Naval hospital enters e— commerce realm 
By Judith Robertson, Naval Hospital Bremerton 

BREMERTON, Wash. - An employee at the Naval 
Hospital Bremerton was the second in Navy Medicine 
community to be awarded for contributions to 
'business-to-business electronic commerce. ' 

Judy Gitchell, lead purchasing agent and system 
administrator for the Standard Procurement System was 
presented with the Gary Thurston Product Integration 
Award. This award is given to agents that are 
leading the Navy's revolution in business affairs. 

"I thank you for your positive contribution to 
the implementation of the Standard Procurement System 
and progress in achieving the goals of the Navy and 
Marine Corps ' paperless acquisition procurement 
process, " said Adm. G.H. Jenkins, Jr., Deputy for 
Acquistion and Business Management, in a letter. 

Years ago it was decided that there should be a 
standardized procurement system within the Department 
of Defense. The Navy started moving toward that goal 
a few years ago and NH Bremerton followed in August 

Gitchell guided her department at the hospital 
through the overwhelming new system and acted as the 
liaison with the hospital ' s Management Information 
Department . She also spearheaded the regionalization 
of procurement processes with Naval Hospital Oak 
Harbor on Whidbey Island. 

"It ties everyone together so we're paperless. 
We used to spend hours at the copier, especially at 
annual contract time. Now we can send the contracts 
by email . It has just saved a lot of time for 
everyone, " said Gitchell . 


Headline: No one gets dogged when it comes to pet 

By JOSN Theresa Raymond, Naval Hospital Portsmouth 

Portsmouth, Va. - Dogs have always been 
considered man ' s best friend. But at Naval Medical 
Center Portsmouth they have become healing 
companions . 

The pet therapy program began in 1997 to comfort 
patients during the healing process . 

According to the 1992 Department of Defense 
Human— Animal Bond Principles and Guidelines, the 
first documented animal facilitated therapy program 
in the United States occurred in 1942 at Pawling Air 
Force Convalescent Center in New York. Dogs were 
used to promote communication and convalescence . 

Since then pet therapy and pet visitation 
programs have been documented throughout the world in 
inpatient hospital settings , community health 
settings, prisons, psychiatric hospitals, 
convalescent centers, rehabilitative centers and 
nursing homes. 

Research has shown the effectiveness of pet 
therapy in increasing communication and decreasing 
the physical and emotional manifestations of anxiety. 

According to the pet therapy program philosophy, 
pet visitation lowers blood pressure and heart rate, 
reduces the need for pain medication and provide 
comfort by their presence . 

The program responsibilities are divided among 
four areas: the pet therapy committee, the health 
care team, staff and documentation. 

The combined efforts of each area ensures the 
coordination and capability of requesting patients 
and pets. 

Doctors verify that there are no known allergies 
to animals or other problems associated with animals 
where the pet therapy is taking place. 

The base veterinarian must also certify the 
animal for participation in the pet therapy program 
by providing each animal with a Veterinary Health 
Certificate, DD Form 2209. 

Hospital sanitation is not compromised by this 
alternative therapy. The staff ensures that owners 
and handlers have their pets leashed or caged at all 
times within the hospital. If the pet appears 
unhealthy, poorly groomed, or ill behaved in any 
manner, the staff has the right to refuse entrance 
into the facility. Then they must notify the pet 
therapy committee chairperson of the disbarment 
within 72 hours. 

Pet therapy is a feasible means of supplying 
additional support and communication modalities for 
patients and it is a unique and alternative way of 
treatment that has extensive potential benefits to 
patients as well as staff. 

NMCP staff members have found innovative, 
entertaining and enjoyable ways to holistically 
address patient's needs. 


Headline: NACC accreditation from College of American 

From Naval Ambulatory Care Center Rhode Island 

NEWPORT, R.I. - Naval Ambulatory Care Center 
Rhode Island main laboratory was awarded 
accreditation by the commission on laboratory 
accreditation of the College of American Pathologists 
June 30, following an on— site inspection. NACC's 
main laboratory is one of the more than 6, 000 cap- 
accredited laboratories nationwide. 

The CAP laboratory accreditation program is 
recognized by the federal government as being equally 
as stringent as the government 's own inspection 
program . 

Inspectors examine the records and quality 

control of the laboratory for the preceding two 
years, as well as the education and qualifications of 
the total staff, the adequacy of the facilities, the 
equipment, laboratory safety, and laboratory 
management to determine how well the laboratory is 
serving the patient . 

The college of American pathologists is a 
medical society serving nearly 16,000 physician 
members and laboratory community throughout the 
world. It is the world's largest association 
composed exclusively of pathologists and is widely 
considered the leader in laboratory quality 
assurance . The CAP is an advocate for high— quality 
and cost-effective medical care. 


Headline: History on display at Naval Hospital 

By Judith Robertson, Naval Hospital Bremerton Public 

BREMERTON, Wash. - Bringing history to life was 
the challenge Naval Hospital Bremerton 's First Class 
Association recently took on as they assembled 
pictures and information on all the commanding 
officers involved in the delivery of Navy Medicine in 
Puget Sound spanning three centuries. 

Searching naval hospital archives throughout the 
country, dusty pictures and yellowing biographies 
were used in the construction of an informational and 
photographic display of the 58 past commanding 
officers who have led the Navy's healthcare providers 
in the Puget Sound area since the 1800s. 

Beginning with Ensign James Stroughton, Passed 
Assistant Surgeon, who commanded the delivery of 
medical care beginning in April 1895, to the present 
Commanding Officer, Capt . Gregg Parker, MC, the "Hall 
of History" reflects the changing emphasis on rank, 
insignia, style of dress and uniforms over the years. 

"Gathering history from the 1800s and early 
1900s was an interesting learning experience, " said 
HMl (FMF) Norberto Martinez, one of the coordinators. 

The Hall of History was officially opened for 
public display at a ribbon cutting June 20. 


Headline: Anthrax question and answer 

Question: How is anthrax diagnosed? 
Answer: Anthrax is diagnosed by isolating the 
bacteria. Bacillus anthracis, from the blood, skin, 
or cerebral spinal fluid, or by measuring specific 
antibodies in the blood of suspected cases. 
Generally, diagnosis by antibodies is done weeks or 
months after the infection occurs, too late to aid in 
treatment . The best protection is vaccination before 

exposure, combined with the appropriate Mission- 
Oriented Protective Posture (MOPP) , including 
protective clothing and detection equi^xnent . 


Headline: TRICASE question and answer 

Question: Is mental health and substance abuse 
recovery covered under TRICARE Prime? 

Answer: Mental health and substance abuse 
treatments are covered under TRICARE Prime with a 
minimal copayment. The cost for outpatient visits 
will be $10 for E-4 and below and $20 for E-5 and 
above. Retirees will pay $25 per visit. The 
copayment s are reduced for group visits. For 
inpatient care the costs are $20 per day for all 
active duty family members and $40 per day for 
retirees . 


Headline: Healthwatch: Car seat safety should take a 
back seat 

By Lt.j.g. Robyn Bent, U. S. Naval Hospital, 

YOKOSUKA, Japan - Motor Vehicle crashes remain 
the leading cause of accidental deaths in children 
under the age of 14. 

Yet proper use of a car seat can reduce the risk 
of death for infants by 71 percent and for toddlers 
by 54 percent . Unfortunately it is estimated that 85 
percent of children in car seats and booster seats 
are improperly restrained. 

To do its job properly a car seat must be 
installed securely against the vehicle's backseat. 
If the car seat slides around on the seat, or if your 
child slides around in the car seat, the child may 
not be adequately protected. 

To check for a tight fit push and pull on the 
safety seat . If it moves more than one inch, you 
need to tighten it . The seat should feel as though 
it is part of the car. If the seat does not securely 
fit in the car because the lap belt extends or 
retracts, use the locking clip supplied with safety 
seat . 

Infants should ride in a rear-facing safety seat 
until they are one-year-old and at least 20 pounds. 
Studies show that what really protects the child in a 
crash are their bones and it takes about a year for 
the bones to harden enough to make the child safe in 
a forward- facing seat . 

The car seat should be positioned in the center 
of the rear seat of the car, facing the back of the 
car. The chest clip should be positioned at mid- 
chest, armpit level. The shoulder straps should be 
at the lowest slots for the newborn. The angle of 

the seat should be about 45 degrees or about halfway 
back in a semi-reclined position. 

Forward-facing car seats should be used for 
children who weigh 20—40 pounds. The seat should be 
placed in the full upright position. The reclined 
position used for the rear-facing seat does not 
adequately protect a forward-facing child. 

Booster seat are use for children who have 
outgrown their car seats are not yet ready for using 
grown-up seatbelts . If children are between 40-80 
pounds they need a booster seat . Parents that use a 
regular seatbelt for their children at this weight 
run the risk of causing severe internal injuries in 
the event of a crash or even an abrupt stop. This 
happens when the seatbelt falls across the neck and 
shoulders of the child causing neck injuries . 

The booster seat literally boosts the child up 
and positions the seatbelt so that the seatbelt fits 
properly . 

Parents should stop using car seats when the 
child's legs are able to hang over the edge of the 
seat touching the floor, and so that the shoulder 
belt falls across the shoulders, not the neck. The 
child should also be at least 8 years old so that the 
hip bones are strong enough to absorb the impact of a 
crash . 

To find out more about car seat safety visit the 
Safe Kids Coalition' s web site at 

To find out if your car seat has been recalled 
please check out 


Comments about and ideas for MEDNEWS are welcome . 
Story submissions are encouraged. Contact MEDNEWS 
editor, at email:; telephone 
202-762-3218, (DSN) 762, or fax 202-762-3224 .